Medications for Cerebral Palsy

Medications for Spastic Cerebral Palsy

Muscle stiffness and tightness, also known as spasticity, is one of the most common challenges for children with spastic cerebral palsy. Medications target overactive and stiff muscles to improve movement and reduce discomfort.

Oral options such as Baclofen (Lioresal, Gablofen), Diazepam (Valium), and Tizanidine (Zanaflex) are often prescribed first in milder cases.

In cases where spasticity is more severe, intrathecal baclofen pumps deliver medication directly to the spinal cord.

Botulinum toxin (commonly known as Botox) can be injected into specific muscles to provide relief from stiffness.

Common side effects from spasticity medications include:

• Baclofen (Lioresal, Gablofen): drowsiness, weakness, dizziness, nausea, low blood pressure

• Diazepam (Valium): sedation, fatigue, confusion, risk of dependence

• Tizanidine (Zanaflex): dry mouth, low blood pressure, drowsiness, liver enzyme changes

• Intrathecal baclofen pump: infection, catheter problems, withdrawal symptoms if pump malfunctions

• Botulinum toxin (Botox): temporary muscle weakness, pain at injection site, flu-like symptoms

Medications for Involuntary Movements

Children and adults with CP may experience twisting, writhing, or jerky movements, especially those with dyskinetic cerebral palsy. Medications can calm these movements.

Trihexyphenidyl (Artane) is commonly prescribed for dystonia and muscle control. In some cases, Clonazepam (Klonopin) is used for tremors or sudden, uncontrolled motions. These drugs do not completely eliminate involuntary movements, but rather reduce their intensity.

Possible side effects of involuntary movement drugs include:

• Trihexyphenidyl (Artane): dry mouth, blurred vision, constipation, confusion

• Clonazepam (Klonopin): drowsiness, fatigue, unsteadiness, risk of dependence

Seizure Control Medications

Co-occurring disorders such as epilepsy and seizures affect up to one-third of people with cerebral palsy, making anticonvulsants an important part of care. Commonly prescribed drugs include Levetiracetam (Keppra), Valproic Acid (Depakote), Carbamazepine (Tegretol), and Lamotrigine (Lamictal).

These medications are known as barbiturates and benzodiazepines which slow down the central nervous system and brain activity, preventing seizures. 

Doctors will often start off with one medication and adjust as needed to balance seizure control with side effect management. Seizure control is important for protecting cognitive development, safety, and overall well-being.

Anticonvulsant side effects to watch for:

• Levetiracetam (Keppra): sleepiness, irritability, dizziness, weakness

• Valproic Acid (Depakote): nausea, tremor, weight gain, liver toxicity, hair loss

• Carbamazepine (Tegretol): dizziness, drowsiness, nausea, low blood counts

• Lamotrigine (Lamictal): rashes, dizziness, headache, sleepiness

Pain Management Medications

Chronic pain in cerebral palsy can result from muscle tightness, orthopedic complications, or daily strain on the body. Over-the-counter options like Acetaminophen (Tylenol) and NSAIDs (Ibuprofen — Advil, Motrin; Naproxen — Aleve, Naprosyn) are used for mild to moderate pain.

For more severe pain, stronger prescription pain relievers (opioids — OxyContin or Vicodin) may be considered. In some situations, antidepressants or anti-anxiety medications like (Fluoxetine — Prozac, Sertraline — Zoloft, Diazepam — Valium) are added to help manage emotional strains from ongoing pain.

Pain relief drug side effects may include:

• Acetaminophen (Tylenol): liver toxicity at high doses

• NSAIDs (Ibuprofen — Advil, Motrin; Naproxen — Aleve, Naprosyn): stomach upset, ulcers, kidney issues, increased bleeding risk

• Prescription pain relievers (opioids — OxyContin, Vicodin): drowsiness, constipation, nausea, risk of dependence

• Antidepressants/Anxiolytics (Fluoxetine — Prozac, Sertraline — Zoloft, Diazepam — Valium): nausea, sleep changes, dizziness, mood changes